What can I do to get into a top PM&R program?

[ShowMeAMiracle]

Hi. I'm a MS3 in a mid-tier US MD school with a home PM&R program. I just started clerkships several months ago and I have high passed surgery and psych. As far as I'm aware, I do not have any red flags other than being an average/below average student during pre-clinicals. My other experiences include:

Research: formerly in a regenerative medicine lab but project was abruptly halted. Currently submitted a case report for a pain/interventional spine projects and hopefully also submitting to AAP's Physiatry '24. Also in a SCI and ALS lab doing independent projects. I have submitted several literature reviews and abstracts to physiatry journals but so far I am still waiting on whether they will be published. I have presented at 2 school conferences during med school and several more during undergrad.

Leadership: on e-board for school's PM&R interest group, also formerly e-board for a cultural group. Founder of a volunteer organization for TBI education. Applied for AAP subcommittee position but haven't heard back yet.

Volunteering: multiple adaptive sports volunteering and Special Olympics volunteering. Also volunteered for the New York Marathon last year and am planning to do so again.

Clinical: I've shadowed several physiatrists in my area but I am a member of my state's PM&R society and have volunteered for them as an ultrasound model. I'm hoping to get more exposure through electives this year.

I guess it's still way early to gauge my competitiveness for PM&R, especially since I haven't taken step 2, but given that my grades aren't spectacular and PM&R is getting more and more competitive, I was hoping y'all could give me advice on how I can realistically improve my chances of getting into my top choice program when I apply next year. My dream is to become a faculty member and teach at a residency program so I am really motivated to go to a very academic PM&R program like Spaulding, Kessler, NW, or Mayo etc.

This is my first time posting here so I apologize for writing so much. I'm still finding my path right now so a lot of this could be unnecessary worrying but I hope y'all can understand. Please let me know if you have any questions! Thank you!!!!!

---

Members don't see this ad.

 

[Slowpoke]

I think you demonstrate genuine interest with the involvement that you've got yourself into. I think that's key. Next steps would be performing well and getting stellar letters from your home PM&R rotation/department, consider signing up for an away-rotation at 2-3 of your top choices, and do well on Step 2. I think you're ahead of the game with the amount of activities you're doing!

 

[j4pac]

I wouldn’t get too worried about not being great in pre-clinicals. Just don’t fail. Do as well as you can with boards, and get exposure/auditions in PM&R

 

[flapjack3d]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

 

[Slowpoke]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

I doubt it.

 

[timisdaman]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

I doubt it.

Not average, but also not uncommon.

 

[j4pac]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

From a student with a home PMR program…it looks like an application that wouldn’t be uncommon. Without step 1 it has become even more difficult to sort out applicant quality. LOR, PS, and auditions are vital to matching.

 

[ShowMeAMiracle]

I think you demonstrate genuine interest with the involvement that you've got yourself into. I think that's key. Next steps would be performing well and getting stellar letters from your home PM&R rotation/department, consider signing up for an away-rotation at 2-3 of your top choices, and do well on Step 2. I think you're ahead of the game with the amount of activities you're doing!

Thank you so much! I'll definitely start interacting with PM&R attendings more now that I can work with them.

 

[ShowMeAMiracle]

I wouldn’t get too worried about not being great in pre-clinicals. Just don’t fail. Do as well as you can with boards, and get exposure/auditions in PM&R

Thank you! I haven't failed anything so far and I am definitely planning to do away rotations as soon as I finish STEP 2

 

[ShowMeAMiracle]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

I was fortunately exposed to PM&R during undergrad so I had a lot of time to decide if PM&R is right for me. My med school is really good at supporting students who are interested in PM&R. We have like 10 different electives for PM&R, a PM&R AI, and a mandatory PM&R rotation. However, because of that, a lot of students here are interested in PM&R and the internal competition is definitely not normal. Most of our applicants have multiple years of research experience, have presented at AAPM&R or AAP, or are PhDs who did research in PM&R. I hope that clarifies my situation a little bit more.

 

[PainDoc2025]

Is this the average PMR applicant now?? Your application would really stand out to me if I were reading it.

Yep, more or less.

 

[PMR2008]

Good application and you will very likely match. Will be tough to match at top 10 because all the people who match will have similar or better things on the CV. I would still apply. Probably 30+ programs. 10 wish, 10 in the middle and 10 safe choices.

 

[ShowMeAMiracle]

Good application and you will very likely match. Will be tough to match at top 10 because all the people who match will have similar or better things on the CV. I would still apply. Probably 30+ programs. 10 wish, 10 in the middle and 10 safe choices.

Wow, thank you, that's really encouraging. I'll definitely try to increase my odds of getting into my top programs through networking and hopefully killing step 2. Would you suggest for me to reach to out PDs now to introduce myself and maybe talk about the possibility of doing aways next year or is it too early?

 

[Slowpoke]

I was fortunately exposed to PM&R during undergrad so I had a lot of time to decide if PM&R is right for me. My med school is really good at supporting students who are interested in PM&R. We have like 10 different electives for PM&R, a PM&R AI, and a mandatory PM&R rotation. However, because of that, a lot of students here are interested in PM&R and the internal competition is definitely not normal. Most of our applicants have multiple years of research experience, have presented at AAPM&R or AAP, or are PhDs who did research in PM&R. I hope that clarifies my situation a little bit more.

Sounds like rutgers. lol

 

[JBM16BYU]

From the activities, research, and leadership you are currently involved in, you definitely show genuine interest in the specialty of PM&R. Like others have said, keep at it, but also make sure to study hard and do well on your Step 2. Letters of recommendation from PM&R individuals who know you well and can easily talk about your attributes, characteristics, and strengths will also definitely help.

When it comes to getting into a "top" program, know that there are many definitions of "top" programs. There are those that are listed at the "top" of Doximity, those whose rehab hospitals are listed in the "top" of the USNWR rankings, etc. Generally speaking, if you are interested in an academic PM&R career, going to a highly academic program will definitely be in your favor. Most likely, not always, but most likely pursuing a fellowship after your residency may help you to stay in academics as well, if desired. You don't have to decide the details of that right now (because if you're at all like me, you'll change your mind a few times while exploring), but something to just keep in mind.

One thing I would think about, while you are doing your clinical years now, is whether you enjoy outpatient clinic and medicine or whether you prefer an inpatient hospital setting. PM&R is 36 months (3 years) after your intern year, of which 12 months are inpatient, 12 months are outpatient, and the other 12 depends on (A) what your specific residency program either deems their strength is, (B) how many electives you have, (C) and the needs of the residency program. For some, they have 12 months inpatient and then the other 24 could be outpatient if desired. Others, vice versa. Still others a mix. This is why some places are considered "outpatient-heavy" or "inpatient-heavy." Personally, I knew from the get go that I would prefer an outpatient practice much more than an inpatient one, so I was drawn to PM&R residencies that provided the 12 required outpatient months (all of them) + the ability to do as much outpatient as possible in the 12 undecided months (a handful). The programs you listed above (Spaulding, Kessler, Northwestern (RIC), Mayo) are all fantastic PM&R programs, but each definitely has their strengths and outpatient / inpatient leanings as well.

 

[drg123]

From the activities, research, and leadership you are currently involved in, you definitely show genuine interest in the specialty of PM&R. Like others have said, keep at it, but also make sure to study hard and do well on your Step 2. Letters of recommendation from PM&R individuals who know you well and can easily talk about your attributes, characteristics, and strengths will also definitely help.

When it comes to getting into a "top" program, know that there are many definitions of "top" programs. There are those that are listed at the "top" of Doximity, those whose rehab hospitals are listed in the "top" of the USNWR rankings, etc. Generally speaking, if you are interested in an academic PM&R career, going to a highly academic program will definitely be in your favor. Most likely, not always, but most likely pursuing a fellowship after your residency may help you to stay in academics as well, if desired. You don't have to decide the details of that right now (because if you're at all like me, you'll change your mind a few times while exploring), but something to just keep in mind.

One thing I would think about, while you are doing your clinical years now, is whether you enjoy outpatient clinic and medicine or whether you prefer an inpatient hospital setting. PM&R is 36 months (3 years) after your intern year, of which 12 months are inpatient, 12 months are outpatient, and the other 12 depends on (A) what your specific residency program either deems their strength is, (B) how many electives you have, (C) and the needs of the residency program. For some, they have 12 months inpatient and then the other 24 could be outpatient if desired. Others, vice versa. Still others a mix. This is why some places are considered "outpatient-heavy" or "inpatient-heavy." Personally, I knew from the get go that I would prefer an outpatient practice much more than an inpatient one, so I was drawn to PM&R residencies that provided the 12 required outpatient months (all of them) + the ability to do as much outpatient as possible in the 12 undecided months (a handful). The programs you listed above (Spaulding, Kessler, Northwestern (RIC), Mayo) are all fantastic PM&R programs, but each definitely has their strengths and outpatient / inpatient leanings as well.

This is excellent advice. Decide what 'top' looks like for you. Substance matters, not just names. Identify your goals and see which places are most aligned with them. If you want to be an outpatient interventionist (spine, pain, MSK), then going to a place, no matter how prestigious, that has you working the inpatient rehab floors 24/7 is poor alignment. And vice versa of course if your goal is to be doing TBI medicine and you're being sent to the fluoro suite all the time. It's about alignment. I chose a place that isn't considered 'top' but in substance, it was absolutely perfrect alignment for my goals.

 

[Butterfly23]

It depends on your goals in your life. If you want to be an academian I totally understand gunning for top ranked residencies. If you are interested in pain medicine as your career, I see more and more residents matching into pain fellowship with acgme accredation! you know why? I feel like anesthesia people are not really gunning for pain fellowships compared to past. If you read pain sdn forum, all those guys are saying pain jobs are getting saturated blah blah blah. Pain anesthesia folks are blaming NASS accredited fellowships for market saturation. So i feel like this original author of this post have gunned enough and if i were you, I will focus on step 2.

Another point i want to make is that the pm&r with poor boundaries and poor definitions, i am not sure how much residency prestige matters as an attending.

Furthermore, pm&r does not follow academic name brands. If i am an employer, I will be hesitant to hire grads from the new fancy ivy league residency from the conneticut!.

Too many residencies in the country, totally unnecessary!

If you want to get good pmr education, gunning for top residencies, is novel thing to do. But at the same time, will FIM scores jump because you graduated from big name residency? absolutely not

 

[PMR2008]

You really think we have too many residency programs?

 

[j4pac]

You really think we have too many residency programs?

There are lots of new programs the past few years, but most are pretty small

 

[Cath Up]

Good application and you will very likely match. Will be tough to match at top 10 because all the people who match will have similar or better things on the CV. I would still apply. Probably 30+ programs. 10 wish, 10 in the middle and 10 safe choices.

Just want to clarify that these are probably low numbers for OP to submit. Programs applied to has shot up in recent years. OP be sure to check the nrmp charting outcomes. Total applied to is probably 50-70

 

[ShowMeAMiracle]

Just want to clarify that these are probably low numbers for OP to submit. Programs applied to has shot up in recent years. OP be sure to check the nrmp charting outcomes. Total applied to is probably 50-70

Noted. I've heard from our M4s that 50+ is the go to now. But with signaling being really important, and PM&R only getting 5 signals, I've been spending more time making a top 10 list of programs I will definitely signal/do an away audition at.

An update for those that care about the struggles of a M3, I recently published my first case report in pain medicine and I feel a lot more comfortable writing manuscripts now. I am also on several other clinical research projects in SCI and neurodegenerative diseases and so far I've been really enjoying research. I'm doing well in clerkships and I will be doing my first PM&R elective in SCI next month! I definitely feel like I've "gunned" a lot this year but I really enjoyed the process of pushing myself to be better and thankfully I haven't stepped on anyone's toes.